FPCITSPECTreportedwithBasGan(V2)andwith ourselfmadesoftware:correlationwithfinal diagnosisatlatefollowup

M.Margheron1,A.Skanjeti1,T.Angusti1,M.Giors1,M.DiFranco2,E.Trevisiol1,V.Podio1.

EANM11(OCTOBER1519,BIRMINGHAM/UK)

1)NuclearMedicineUnit,UniversityofTurin,Orbassano,ITALY. 2)HospitalPharmacy,SanLuigiGonzagaHospital,Orbassano,ITALY.

Introduction: [123I]ioflupaneSPECT is widely used to assess extrapyramidal diseases. Its evaluation is usually both qualitative and semiquantitative. BasGan (V2)has been proposed as a tool to uniform images
evaluationbytheuseofautomatedvolumesofinterest(VOI).Furthermore,thissoftwareallowsthecomparisonof resultsfrompatientsandfromhealthysubjectsaccordingtoage.

Aimofthestudy

accuracy of BasGan and of a software developed in our institutionandtorelatedresultsofbothapplicationswithdiagnosis.

to assess
SelfmadesoftwareROIs BasGansoftwareVOIs

Materialsandmethods: SPECTs from 59patients (age

68+/8 years, 32 M and 27 F), obtained in 2006 and 2007. Final diagnosisestablishedbytheneurologistsaccordingtoallrelevant data; diagnosis were dicotomized (Parkinson disease and parkinsonisms vs. essential tremor and nonextrapyramidal disease). BasGan (V2) builds full3D VOIs of both caudatesandputaminawhileoursoftwareanalyzesasingle2 cm thick slice with ROIs of caudates and putamina. In all occurrences, we considered the worst result of the two caudates as caudate result and the worst value of the two putamina as putamen.WeconsideredBasGanrawdata,theirratiotoand difference from agerelated normal values (BG, N and D respectively).Statisticalanalysisbylogisticregression,according to final diagnosis; finally ROC curves were used to assess the bestcutoffandtheaccuraciesofbothsoftware.
SQ Putamen P(value) <0.001 minimum %casescorrectly 75% classified Caudate minimum P(value) %casescorrectly classified BG 75% N 71% D <0.001 71%

Images from a 60 years old women: they were obtained with dualhead camera with LEHR parallel hole collimators, 120 images/360, 40 sec/image, pixel size 2.92mm.

Results: all results showed a good correlation with

final diagnosis. With BasGan results, logistic regression demonstrated a significant correlation

<0.001 <0.001

<0.00001 <0.0001 <0.0001 <0.0001 80% 81% 81% 80%

between final diagnosis and caudate values (p<0.001) as well as putamen values (p=0.0001); our selfmade software gave similar
results. The obtained eight ROC curves showed high AUC values (range 0.820.89, p0.0001 for all occurrences).
Inthetable,thelogisticregressionresults. SQ=selfmadesoftwarevalues; BG=BasGanrawdata; N=BasGanratiofromagerelatednormalvalues; D=BasGandifferencefromagerelatednormalvalues. ROC curves on the left are referred to putamen minimum results, obtainedbothwithBasGanandselfmadesoftware.

Cutoff:2.19 AUC=0.868 Pvalue=0.0001

Cutoff:1.04 AUC=0.891 Pvalue=0.0001

Conclusion: BasGan(V2) and our selfmade software showed similar great accuracies in reporting FPCIT SPECT images. However, BasGan working with automated VOIs is more operator independent than the inhouse software. On the other hand, BasGan could be used to uniform cutoff in multicenterstudy:thisisournextgoal.